Cancer Incidence in World Trade Center Rescue and Recovery Workers, 2001–2008

Abstract

Background: World Trade Center (WTC) rescue and recovery workers were exposed to a complex mix of pollutants and carcinogens.Objective: The purpose of this investigation was to evaluate cancer incidence in responders during the first 7 years after 11 September 2001.Methods: Cancers among 20,984 consented participants in the WTC Health Program were identified through linkage to state tumor registries in New York, New Jersey, Connecticut, and Pennsylvania. Standardized incidence ratios (SIRs) were calculated to compare cancers diagnosed in responders to predicted numbers for the general population. Multivariate regression models were used to estimate associations with degree of exposure.Results: A total of 575 cancers were diagnosed in 552 individuals. Increases above registry-based expectations were noted for all cancer sites combined (SIR = 1.15; 95% CI: 1.06, 1.25), thyroid cancer (SIR = 2.39; 95% CI: 1.70, 3.27), prostate cancer (SIR = 1.21; 95% CI: 1.01, 1.44), combined hematopoietic and lymphoid cancers (SIR = 1.36; 95% CI: 1.07, 1.71), and soft tissue cancers (SIR = 2.26; 95% CI: 1.13, 4.05). When restricted to 302 cancers diagnosed ≥ 6 months after enrollment, the SIR for all cancers decreased to 1.06 (95% CI: 0.94, 1.18), but thyroid and prostate cancer diagnoses remained greater than expected. All cancers combined were increased in very highly exposed responders and among those exposed to significant amounts of dust, compared with responders who reported lower levels of exposure.Conclusion: Estimates should be interpreted with caution given the short follow-up and long latency period for most cancers, the intensive medical surveillance of this cohort, and the small numbers of cancers at specific sites. However, our findings highlight the need for continued follow-up and surveillance of WTC responders.

Occupation and Thyroid Cancer

“…They found excess thyroid cancer incidence in a group of occupations including protective services, construction, building and ground cleaning and maintenance, electrical, telecommunications and other installation and repair groups (CM&IRG); and all other occupations related to the rescue and recovery work of WTC compared to the incidence of general population in the United States. However, the increased risk was not observed when limited those working in protective services group and CM&IRG (40). Pukkala et al (23) reported a significantly increased risk of thyroid cancer in female building care takers.…”

“…Few studies have highlighted the association between building cleaning, ground cleaning, and maintenance occupations and thyroid cancer. Solan et al (40) examined cancer incidence in World Trade Center (WTC) rescue and recovery workers during the first seven years after September 11, 2001. They found excess thyroid cancer incidence in a group of occupations including protective services, construction, building and ground cleaning and maintenance, electrical, telecommunications and other installation and repair groups (CM&IRG); and all other occupations related to the rescue and recovery work of WTC compared to the incidence of general population in the United States.…”

World Trade Center Disaster Exposure-Related Probable Posttraumatic Stress Disorder among Responders and Civilians: A Meta-Analysis

“…The overlaps in participants among the three programs ranged from less than 1% between the WTC-HP and FDNY to approximately 20% for responders between the Registry and WTC-HP [27]. The total number of FDNY participants ranged from 1159 to 8869 for each of the nine survey cycles between 2001 and 2010 [6].…”

Spatiotemporal Co-existence of Female Thyroid and Breast Cancers in Hangzhou, China

“…Some studies have considered the relationship between iodine intake and TC risk, but their results are rather inconclusive203031. Endocrine disrupting compounds such as polychlorinated biphenyls (PCBs), polybrominated diphenyl ethers (PBDEs) and pesticides, which can disturb thyroid function, have been linked to carcinogenesis through a variety of mechanisms323334. TC is gender-biased, i.e., it is more common among females than among males with a female to male ratio of about 3 to 1 in the general population35.…”

“…While stochastic associations do not usually imply necessary and sufficient causation criteria, they offer useful insight into such a complicated situation of considerable public health significance3244. Studies of disease associations in human populations involve a variety of techniques, including visual comparisons of the patterns exhibited by the disease factors, statistical analysis of population disease occurrences across a geographic area, multi-perspective analysis, and geographical information systems techniques304546474849.…”